Osteosarcoma: MR imaging after preoperative chemotherapy.
The authors reviewed 76 magnetic resonance (MR) images of 38 patients with osteosarcoma treated with preoperative chemotherapy (intraarterial cisplatin with or without systemic chemotherapy). Histologic maps of the surgical tumor specimens in 33 cases were correlated with either late-chemotherapy or postchemotherapy MR images. There were four MR patterns--dark, mottled or speckled, homogeneous, and cystic--that corresponded to different amounts of tumor matrix, granulation tissue, hemosiderin deposits, fluid-filled cysts, and residual viable tumor. Nested foci of residual viable tumor could not be specifically identified, although tumor progression or skip metastases were accurately depicted in four patients. Other findings included (a) peritumoral edema in the soft tissues and intramedullary space that shrank with chemotherapy, (b) chemotherapy effect in the surrounding soft tissues, (c) a dark rim around the extramedullary component of the tumors corresponding to a collagenous capsule continuous with the periosteum, (d) development of metaphyseal hemorrhages and bone marrow infarcts, and (e) intramedullary vascular channels.
Pan
G
G
Department of Diagnostic Radiology, University of Texas M.D. Anderson Cancer Center, Houston 77030.
Raymond
A K
AK
Carrasco
C H
CH
Wallace
S
S
Kim
E E
EE
Shirkhoda
A
A
Jaffe
N
N
Murray
J A
JA
Benjamin
R S
RS
D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001853:Bone Marrow / Q000473:pathology; D001859:Bone Neoplasms / Q000188:drug therapy / Q000473:pathology*; D002648:Child; D002675:Child, Preschool; D002945:Cisplatin / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D004487:Edema / Q000473:pathology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D009336:Necrosis; D012516:Osteosarcoma / Q000188:drug therapy / Q000473:pathology*; D011300:Preoperative Care; D012189:Retrospective Studies
D004317:Doxorubicin; D002945:Cisplatin